Summary
Performs non-medical reviews and processes redetermination letters.
Description
CGS Administrators provides a variety of services, under contracts with the Centers for Medicare and Medicaid Services (CMS) for beneficiaries, health care providers, and medical equipment suppliers in 33 states, supporting the needs of more than 20 million Medicare beneficiaries nationwide.
We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team!
Logistics:
Logistics: CGS –one of BlueCross BlueShield's South Carolina subsidiary companies.
Position is onsite at Century Blvd, Ste ST610, Nashville, TN 37214-3685
Work hours: Eight-hour shift starting between 6:00 am and 9:00 am Monday through Friday allowing you to work the schedule that best fits your needs after training.
What you will do:
Perform non-medical reviews and process redetermination letters ensuring timeliness and accuracy.
Prepare unit reports, analyze and interpret workload, and process issues utilizing various software tools.
Update letters and documents within the department when necessary.
May gather and prepare documentation for legal inquiries and administrative requests.
What you need to qualify:
High School Diploma or equivalent
Two years job related field (insurance claims, medical office, or similar).
Demonstrated proficiency in word processing and spreadsheet software.
Excellent organizational, customer service, and written and verbal communication skills.
Good judgment skills.
Proficiency in spelling, punctuation, and grammar skills.
Microsoft Office.
What we prefer you have:
Excellent computer skills with the ability to navigate between multiple software platforms and work on multiple computer screens.
Intermediate Excel skills.
Medical claims processing, appeals, billing, or coding experience.
What We Can Do for You:
Our comprehensive benefits package includes:
401(k) retirement savings plan with company match & annual enhancement
Subsidized health plans and free vision coverage
Life insurance
Paid annual leave — the longer you work here, the more you earn
Nine paid holidays
On-site cafeterias and fitness centers in major locations
Wellness programs and a healthy lifestyle premium discount
Sports membership program
Tuition assistance
Service Recognition
Equal Employment Opportunity Statement
BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations.
We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.
If you need special assistance or an accommodation while seeking employment, please email [email protected] or call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.
We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information.
Some states have required notifications. Here's more information.
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What We Do
For more than six decades, BlueCross BlueShield of South Carolina has been part of the national landscape. Our roots are firmly embedded in the state. We are the largest insurance company in South Carolina. We are also the only one that has an A+ Superior A.M. Best rating. We are one of the nation's leading government contract administrators. We operate one of the most sophisticated data processing centers in the Southeast and have a diverse family of subsidiary companies. Our full-time employees enjoy benefits like a 401(k) retirement savings plan with company match, subsidized health plans, free vision coverage, life insurance, paid annual leave and holidays, wellness programs and education assistance. If you are a full-time employee in the National Guard or reserves, we will cover the difference in your pay if you are called to active duty. BlueCross has a dedicated corporate culture of community support. Our employees are some of the most giving in the country. They support dozens of nonprofit organizations every year. If you're ready to join a diverse company with secure, community roots and an innovative future, apply for a position now!
